Strategy for ischemic biliary injury after liver transplantation

2022 Fiscal Year Final Research Report

• Project/Area Number: 19K09096
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 55010:General surgery and pediatric surgery-related
• Research Institution: Ehime University
• Principal Investigator: Ogawa Kohei 愛媛大学, 医学系研究科, 准教授 (10359789)
• Co-Investigator(Kenkyū-buntansha): 坂元 克考 愛媛大学, 医学部附属病院, 講師 (50790218) ; 本庄 真彦 愛媛大学, 医学部附属病院, 助教 (90807926)
• Project Period (FY): 2019-04-01 – 2023-03-31
• Keywords: 肝移植 / 血液型不適合移植 / 虚血性胆管障害 / 動物モデル

Outline of Final Research Achievements

Antibody-mediated rejection in blood group-incompatible liver transplantation can cause late-onset progressive bile duct injury, leading to graft loss. Ischemic cholangitis due to intrahepatic microcirculatory disorder is thought to be the cause of bile duct injury. The purpose of this study was to create an animal model of ischemic bile duct injury caused by this microcirculatory disorder and to establish a therapeutic strategy. It was suggested that a model of ischemic bile duct injury similar to actual clinical practice could be created by adding heterochronous arterial ligation to a rat arterial reconstruction model of liver transplantation. In the future, we plan to investigate the effect of drugs that improve circulatory disorders (antiplatelet drugs, anticoagulant agents, etc.) and drugs that promote angiogenesis (VEGF, bFGF, etc.) on ischemic bile duct injury.

Free Research Field

肝移植

Academic Significance and Societal Importance of the Research Achievements

近年、脳死肝移植が徐々に増えつつあるが、欧米と比較して本邦の肝移植医療において生体肝移植の占める割合はまだまだ高く、血液型不適合肝移植は避けては通ることは出来ない。本研究により実臨床を反映した遅発性虚血性胆管障害の動物モデルが作製出来る可能性が示唆された。今後このモデルを用いて虚血性胆管障害を軽減させることが出来る薬剤が見いだせれば、血液型不適合肝移植後の胆管合併症の軽減につながり、長期の肝移植成績向上に寄与するものと思われる。